NYC-WTC_000166105

NYC 9/11 Public Portal Document

1f' r ETY DIRECTOR ON SITE EXAMII '(C -OFFICE Section D: VII. Comments by Examiner. The Class E system was inoperative, candidate was advised to send in an affidavit indicating proper instruction has been provided and system Check if is operative. If so, state why system was inoperative. applicable _-

VIII. Determination of Passing: A. if the candidate failed to answer satisfactorily the essential questions marked (*), advise the candidate that a new appointment should be requested by contacting the High Rise Unit. The examiner should also give the applicant a bill for the inspections/examination. B. If the candidate satisfactorily answered the mandatory parts, but by totalling all answers, the number of NO answers were below 80%, the candidate fails the practical test. See Chart.

IX. On Site Office Building Tbst—(Print ALL Information): C. of F Z 01 ~ C i f )No. of On Site Tests

Candidate Name b 3 a-_'Z i 9/ '~ l~ / f~ Premise Address L4 2 '-- . Tr i P Social Security No.t~ ' ,Ivy u J i ,y Date of Examination I / 2// Total Number of Items Answered,

Number of correct answers are on this test. Number of incorrect answers are — . Number of N/A answers are Cf

Summary of Results: A. PASSED or B. FAILED—(reason) (CHECK)

CANDIDATE BUILDING Those candidates tailing should contact the High Rise Unit for another appointment when building correction and/or additional knowledge is obtained. C. Violation numbers issued as result of examination and Inspection: D. I here certify all info Lion contained in this report is accurate. ~r r^~

INSPECTOR DATE

White copy must be given to the Candidate. Canary copy must be submitted to the High Rise Unit. INSPECTORS ARE ONLY PERMITTED TO PROVIDE CANDIDATES WITH Pink copy must be submitted to Cashier's office. SECTION D. r-SU-1 HIM (UM) 2-B7O5ea m

NYC-WTC 000166157